Graduated: 2003
Also: ADDICTION MEDICINE
NPI: 1487885513
Practice Locations (2)
KENT COUNTY CMH AUTHORITY
790 FULLER AVE NE
GRAND RAPIDS, MI 495031918
6168255412
STATE OF NEW YORK COMPTROLLERS OFFICE
100 PATRIOTS RD
STONY BROOK, NY 117903318
6314448630
Source: CMS National Downloadable File, September 2026.